Multifocal Intraocular Lenses – a Solution for Three Pairs of Eyeglasses
Today's lifestyle is leading us to strive for perfectionism: to look good, to eat well, to earn well. The development of technology and new, everyday solutions leads us to solve even the smallest things that are uncomfortable for some people. Thus, medicine, following in the footsteps of all technological development, is increasingly striving to improve its services. Eyeglasses, especially if it is necessary to wear several pairs for different purposes, are already becoming a problem for many people. Therefore, people expect that a solution will be found to perform the functions of three pairs of glasses.
Why three pairs of glasses?
Very often, patients are surprised that they cannot wear the same pair of glasses to watch TV, read a book, and work on a computer. They are often surprised and worried when they lose focus, have difficulties reading, and similar symptoms.
However, this is a normal physiological process, where the human lens loses its accommodation (and thus its ability to focus) through life. The main task of ophthalmologists is prescribing reading glasses that will replace the lack of accommodation. Starting at age 40, and every five years thereafter, this diopter increases.
Also, age doesn’t matter when it comes to wearing eyeglasses, as nowadays almost all work is concentrated on a computer, which increases the need to wear glasses. However, sometimes the computer is very close to your eyes, or the TV is too distant for you to see things clearly. This means that to function normally and with a clear vision, it is necessary to have three diopters. One solution is to wear progressive glasses, where those diopters will be placed on each lens, and the new, more modern solution is the removal of diopters.
What are multifocal intraocular lenses?
Multifocal intraocular lenses intraocular lenses are the state-of-the-art ophthalmic solution for providing good vision at all three distances. Multifocal intraocular lenses have two or three foci and allow the patient to have good vision at different distances without glasses.
The intervention for the implantation of multifocal lenses is short and painless surgery. It is performed with a local anesthetic and lasts only ten minutes. The natural lens of the eye is removed and replaced with a compatible lens. After the intervention, the patient leaves home the same day with perfect vision. Their advantage over other methods is that they are a permanent solution and do not need to be hygienic, be removed, or put on. After implantation, you will not feel them and will not need to adjust them, because they perform the function themselves and your vision is clearer with more vivid colors.
What are the ways to remove the diopter?
The best-known way of lowering diopters is LASIK2, popularly known as the "laser method," which is the most widely used way of lowering diopters. It is recommended for young people up to the age of 40, because then we still do not have a problem with eyesight. After the age of 40, this method would solve the problem of seeing into the distance, but for close up and computers, glasses would still be needed. What ophthalmology offers as a solution is the application of multifocal intraocular lenses, which, as the name suggests, corrects all foci of vision (i.e. distance, medium distance, and proximity).
Usually, the next question is whether these lenses are durable. Yes, these lenses are intraocular, they are implanted inside the eye, where the natural lens normally sits. This means there is no need to take them out and put them in, and they will last for your lifetime.
The benefits of multifocal lenses
Multifocal lenses are perhaps the closest thing to a natural lens and a natural way of looking. In addition, considering the cost of glasses and soft contact lenses, multifocal lenses are a good long-term investment. By getting rid of glasses, you can have a more active life, and, moreover, the visible field is much wider than that with glasses. Furthermore, they do not change but are implanted once and are there for life. This is especially important for patients who work several hours a day on a computer.
Another obstacle to visual acuity that comes with age is the appearance of cataracts (i.e. blurring of the natural lens). Annually, over 10 million people worldwide are operated on for cataracts. Cataracts are the most common cause of vision loss over the age of 50.
The positive thing about this method is that with the removal of the natural lens and the implantation of an artificial intraocular lens, the problem of cataracts is solved for life (i.e. there is no possibility for them to reappear).
Who are the candidates for multifocal lenses?
If the patient is over 30 years old and wears glasses for distance, medium distance, and proximity, multifocal lenses are a great refractive solution3. In patients who have genetically damaged vision and must wear a diopter from an early age, multifocal lenses address diopter problems. For people who want an active life, and for whom eyeglasses and soft contact lenses are an issue, this would solve the problem.
Multifocal lenses are not recommended for young people who have good accommodation or for people who have changed in the posterior segment of the eye, most often degenerative (senile macular degeneration), changes in diabetes, vascular changes, etc.
To find out if you are a candidate for such lenses, it is necessary to perform a complete examination, with recordings of the front and back segment of the eye and an examination of a wide pupil.
What to do after surgery?
For the first three days after surgery4, you should avoid washing your face with plain water or rubbing your eyes, and for the first month, you should avoid strenuous physical exertion (such as lifting heavy objects). It is especially important to use the prescribed therapy regularly and correctly. Usually, sports activities are allowed 2–3 weeks after the operation, depending on the patient's age and the intensity of exercise. 
Final thoughts
Multifocal lenses allow you to see clearly at different distances without glasses: far, medium distance, and near. The various designs of multifocal lenses that are available around the world allow an individualized approach so that the patient ca choose the design that best suits their lifestyle. The benefit is great, especially in terms of quality of life, because of the comfort these lenses offer. The limitations patients used to have with eyeglasses and regular lenses are no longer there. It gives them tremendous freedom and confidence to carry out their daily activities, whether it be work or leisure.
1. Alio JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: An overview. Surv Ophthalmol. 2017 Sep-Oct;62(5):611-634. doi: 10.1016/j.survophthal.2017.03.005. Epub 2017 Mar 31. PMID: 28366683.
2. Yanoff M, et al., eds. LASIK. In: Ophthalmology. 5th ed. Elsevier; 2019. Accessed August 15, 2019.
3. Kevin M. Miller, MD. The Ideal Multifocal Candidate. Accessed May 2019.
4. What should I expect before, during, and after surgery? U.S. Food and Drug Administration. Accessed August 15, 2019.